...to send possible ASD daughter to nursery earlier than necessary?

[VivienneGold]

Looking more for advice than an AIBU tbh.

A bit of background, DD has just turned two and DH and I were fairly sure a couple of months ago that she has autism. Since then she seems to have outgrown a few of the signs she was demonstrating though the main things remain the same. She is still due to begin any assessments, as HV wasn’t certain at the time of her last appointment either, so we’re still in the unknown, waiting part of it all.

During our looking into it all, we found out that in England and Wales if children her age are diagnosed this young, they then qualify for the free space for two-year-olds at nursery because it’s meant to be beneficial to their development. Can anyone confirm this is the case – i.e. that it would help her in the long run if she is ASD to begin nursery now?

We don’t qualify for this in Scotland, but we can afford to pay for it, so we have enrolled her two mornings a week at a private nursery, but I am feeling very nervous about it all, particularly as she doesn’t have to go for childcare reasons as I’d just be at home. She has had four settling visits and, although she does fine for the first little while, she eventually becomes very upset to the point she is inconsolable until we finally leave (first visits after 50 mins, the next two after about 1.5 hour).

Does anyone have any advice/experience with this? Very torn over whether or not to push on with it.

I think that nursery could be very traumatic to a little one w autism and any possible gains in socialization and communication would need to be carefully balanced against that.

Is your dd usually keen on other children? Is she easily overwhelmed by noise/busy environments? How good is her understanding/communication now?

How good is her communication and understanding? At 2 my son had huge speech delay and could not follow instructions. He did go to nursery as i work and he was ok with it. He was diagnosed at 3. However i don't think it helped his social skills as he was completely in his own little world and was happy doing his own thing.

My severaly autistic son went aged 3 to nursery In a school for children with severe disabilities. Before that he had portage where a key either would come out each week and give us things to work on! Have you been referred to a paediatrician?
I think any dirt if socialisation is good. My ds hated supermarkets he still dues but he can cope because we've never just hidden him away from the things he doesnt like !!!
For your HV to suspect ASD this young your DC must be severe !

ds went to nursery from 9 months old till school because of work. It was nursery that picked up his autism traits! They were fabulous, well trained/ versed and proactive in all this, working with the NHS . They knew how to "deal" with his autism sooooo well! He loved nursery and they were great in transition from baby- toddler- preschool- reception. If its a nursery like mine was, it wont be traumatic if done well. Ds came on leaps and bounds and learned socialisation etc. Rather than isolation at home and it being a bigger shock later. Dont hide them away, that`ll make it all even worse.

Thanks for the replies!

Her communication and understanding aren't great verbally. She does 'tell' people what she wants by going, taking their hand and taking them to what she wants if she wants to go outside, something to eat, down stairs, read a book etc. She understands (but doesn't like) 'no' and knows when she isn't getting what she wants and get very upset - but I'm not sure if that is just usual toddler behaviour?

She doesn't interact with other kids but she sometimes watches them and might copy them. Most times she does seem to be in her own little world. She used to be a lot more interested in other kids when she was younger but she hated baby groups when she was little and they always ended up in tears so, eventually, I stopped taking her (which I fear was the wrong decision?). She is happy enough at soft play, parks etc where there are lots of other people and doesn't seem bothered by nose - her things is movement, she hates trikes, bikes, swings, everything that moves with her on it except the buggy. She only becomes overwhelmed when adults speak to her - she tends to ignore them or shy away, and if they persist she becomes upset.

Very torn over what to do as both options (keeping her at home with me or sending her in) seem to have potentially bad outcomes and worry about making the wrong decision.

We were in the USA at this age so dd attended a special integrated nursery part time (sessions were 90 mins twice a week until 3, plus 2 1 hour 1:1 aba) then 4 days a week from 3-5 2.5 hour sessions. They were specially trained teachers leading the sessions (all with masters) and the assistants were all in training. It was brilliant - BUT we had tried a private nursery and it was a disaster, it's how we got referred for diagnosis in fact. Until 4 you meet the learning needs of children at home combined with parent and toddler groups so I would be so wary about a private nursery unless they had the right training, it really affected dd when (due to her birth date) she had to go to a non specialist place for 4 months.

From what you say it does sound like some time at the right nursery (a calm one w structure and support) would benefit her but I don't think it matters whether you start her at 2 or 3. If you want to delay nursery for a while then you could look for other activities - singing group/aquababes etc - to try in the meantime.

And please don't beat yourself up over baby groups. They are for the mums, and just because a baby learns to tolerate something doesnt mean they are actually benefitting in any way.

I think it very much depends on the setting and how good they are at supporting your child and working with you and outside professionals.

Often there is funding available without a diagnosis, and the senco at the nursery should discuss what is possible, and how they will support any difficulties she has.

When ds started at a preschool, I was able to attend with him for the first few months, leaving very gradually for a few minutes at a time until he was happy there with a key worker who worked brilliantlywith him.

OP most kids under the age of 2 don't interact much if at all with other kids. It's a period of solo play. Unless they have older siblings or close cousins/friends they see every day it's unusual for kids younger than 2-2.5 to interact that much at all. They'll play in the same space but not together, if you get what I mean. It's a development thing. What other traits make you think she is autistic?

I wouldn't say that nursery helped our son with his autistic traits, but it helped enormously with his learning and development - being around other children, watching them play, watching them feed themselves. Plus it really helped having a professional nursery involved when applying for his EHCP..

I don’t think she will gain much from being in a nursery setting now as opposed to at 3. Especially if she is finding it upsetting. We tried at 2 with dd and she was inconsolable so stopped after one session. She has since restarted at 3.2 and still doesn’t particularly want to go but enjoys it once she’s there and is no longer hysterical. I have no regrets keeping her home the extra year.

It must be a harder decision as you’re unsure if she has asd but even then I agree with a pp that unless the setting is fully equipped and qualified with working with children with asd then it is likely she will find it even more distressing.

As others have mentioned, it depends on how well equipped the nursery is and how well your DD settles there. Each child with ASD is so entirely different from the next that it would be silly to assume she'll settle well simply because someone else's child did.

DS13 has ASD and went to nursery when he was 6 months old 4 days a week as his Dad and I had split up and - ultimately - there was no alternative if I wanted to keep the house. We made it work and he's very sociable, very happy and generally his ASD isn't a huge part of his life - I credit his nursery with a huge part of how well he integrated into school and how sociable he was from a young age. I think I knew from around a similar age that DS was on the Autism spectrum, and nursery supported the diagnosis and made sure their support echoed what we did at home so that there was consistency and security.

I'd echo others and suggest you research the nurseries local to you and make sure you pick the absolute strongest one for her because they will need a deeper understanding of who she is and how she functions. DS13's nursery was incredible at helping him handle himself and understand his emotions; he wasn't terribly verbal til around 3 but nursery communicated with him in other ways which meant far fewer frustrations for him.

Thanks so much for the replies!

It is a small nursery, with about ten 18 month - 36 month olds in her room at the moment. I stayed for her first two sessions and am very happy with the nursery itself and how all the children there were treated and seemed very happy and comfortable with the place and the girls taking care of them.

IceBearRocks I'm not sure if the HV does suspect ASD, as she played it all very close to the vest when she was out, it was more myself, DH and in-laws that picked up on signs. My parents are adamant she is NT - they have her three times a week while I work.

Is it unusual for children to display signs so young? DD has almost no speech (but babbles), doesn't play with toys just lines or piles them up obsessively (has stopped this now), has very poor eye contact, though this has improved a lot in the last few weeks with me, DH and my parents, very rarely responds to name, can't hold a spoon or crayons (but can very lightly use an aquadoodle pen), has just started walking on tip toes occasionally, only really enjoy playing that involves counting, letters, shapes or colours, would watch TV for hours if we let her - especially shows that involve these things! In fact, one of the only ways to comfort when she is upset is to start counting or saying the alphabet to her, which gradually calms her.

It's great to hear that nurseries have been supportive of ASD kids for a number of posters. The experiences a couple of you have mentioned about how it helped their integration, learning and development were what initially encouraged DH and I to consider and enroll her at this particular nursery.

DD often just ignores us when we try to engage her in playing 'appropriately' (for lack of better words) with toys, or encourage her to use feeding utensils etc. If I leave a spoon in her food she just eats around it with her hands, no matter how messy the food is (beans, tuna and baked potato, pasta bolognaise!). As she will sometimes watch and copy other children and we don't have any nearby young kids in the family or friends with kids her age, we thought a nursery setting might help bring her on in those areas. On the other hand, that would be counterproductive if she is too distressed when there.

My parents have hinted, but not outright said, that they think I am worrying over nothing and that I should just let her develop at her own pace, while in laws are pushing for formal assessments. DH is very laid back and thinks it will all be fine either way.

The thing to remember is that so many behaviours at that age could be ticks on the ASD list, but could also be just how she plays/behaves and unless you're a qualified practitioner, you're not able to say categorically what's going on, so as much as your parents might feel one way, and your in laws another, neither side knows enough to give any sort of definite answer.

The most important thing above it all is that you roll with her; if she's happy with repetitive playing, go with it. If singing number or alphabet songs soothes her, do it. Formal assessments might come, but in the meantime just physically being 'there' and engaging with her on her own terms will mean you know her better than anyone.

If you're happy with how nursery support and nurture her, the benefits could be huge. But play it by ear and assess it as she develops; what you choose now can simply be based upon "this works now" and in six months time things might change and you might need to put new support in place. And it's ok; you're just doing your best and working with what you hope is best for your DD; every parent is doing exactly the same no matter how easy they make it look.

A child on the spectrum might find the noise, the lights etc of nursery too much. A smaller setting that offers the same curriculum and funded hours like a childminder might be better. Health Visitors tend to recommend nursery as they don't realise that childminders work to the exact same standards.

Plus, as a parent of two children on the spectrum, trust your instincts. You know your child best.

I started the diagnosis process with ds on his second birthday, I kept being told repeatedly to get him into preschool and socialising asap. I did that but only because I found somewhere that I knew were educated about autism, but also were willing to learn more about it and took all advice from professionals involved with ds. He spent 2 years there and came along so so much in that time. On his last day I cried so much that he had to leave this preschool who had been so caring to him and I could never thank them enough for what they did for him. So looking back it definitely was the best option for him, but I would say make sure you are 100% sure they are willing to put in the extra time attention and care that your child needs.

I have 2 children with ASD, and I'm not a big fan of mainstream nurseries TBH. We had some awful experiences with one in particular.
If your child is persistently upset I would take that to mean they aren't ready yet.

Also i have my doubts about the supposed benefits of nursery at this age, particularly for children with ASD. Many children with ASD don't learn to socialise simply by being in the presence of other children. That's kind of the whole point. If they could learn these skills so easily they would have picked them up from their family. They need implicit teaching and a lot of extra support, which I think is beyond the remit of a mainstream nursery.

OP if you're in Scotland check out the "It's a Good Time to be 2" initiative, it gives 2 year olds free hours at certain nurseries. Although it's predominantly marketed to those on benefits there are places allocated to children with suspected developmental issues. My DD was accepted into one attached to our local school nursery as soon as we started the assessment procedure for ASD which wasn't confirmed until she was almost 3. It helps with the assessment as staff can report back to the community paediatrician on their behaviour around their peers so if you can you should ask the paed or HV for a referral onto the scheme.

What I will also add is that I do feel it benefited my daughter immensely although it was hard going for the first couple of months trying to get her settled. Staff will work with you towards this as they should have had extra training around ASD etc.

DD's first proper day isn't until tomorrow, thus far it's just been visits that she's been in for, so it's early to tell if she will be unable to settle there. A few friends have told me that their (NT) kids have a bit of trouble the first couple of weeks of starting as well so we probably won't know right away - unless she's hysterical, that is, then we wouldn't persist with it.

FudgeBrownie - thanks for you advice. I often flip-flop myself on whether or not her behaviour points to ASD. She is very affectionate with me and has never been bothered about routines being broken, busy environments and the like, so sometimes I do wonder if her quirks are just her personality. Neither me nor DH are particularly social ourselves either, which also makes me lean the other way, but now that ILs have an opinion we are under a bit more pressure to 'do something' about it, so to speak.

Underachiever do you mind if I ask what the awful experiences at the mainstream nursery were? DD will eventually have to go to one even if we decide not to send her to this one now, which is a private nursery. It was more development than socialisation that we were concerned about at the moment (especially with DH and me being pretty quite people ourselves) and with DD often learning from watching other children we thought this might help with that.

Also if you feel the HV is dragging her feet starting the assessment process take her to the GP instead, they can refer her to the Community Paediatrician. My HV was not helpful at all but the GP referred us straight away & DD had her first appointment with the CP around 6 weeks later.

Thanks so much CrabbitArse for the info, I knew there was spaces for two year olds for those on benefits but didn't realise it was available for suspected ASD as well. I'll have a look into it, from other searches I've done anywhere that specialise in ASN that I've found around here tend to be for ages 5+.

The setting my daughter went to had 18 spaces & 4 of those were kids with suspected ASD, none of whom had parents on benefits